Overview of command and control issues: Setting the stage

Abstract

Sudden-impact disasters typically result in mass casualty incidents that strain local medical resources. However, whether in the United States where local emergency medical systems and ambulance services are typically robust or overseas where they may not be so mature, these disasters tend to produce relatively standard and predictable consequences. The timeline for the response and the physical and psychiatric injuries they produce have been well described in the literature, can be modeled, and can prove to be invaluable to medical planners and operators. This article will review selected aspects on how this information helped prepare and oversee medical responders to the plane crash at the Pentagon on September 11, 2001, high-lighting the command and control aspects of the disaster response. Understanding the setting better facilitates the lessons learned in providing mental health support to this horrific event.